Nature of Business and Accounting Policies - Revenue Recognition (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Jan. 01, 2019	Jan. 01, 2018	Jan. 01, 2017
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Contract liabilities	$ 62,300				$ 24,900				$ 62,300	$ 24,900
Revenues related to performance obligations									24,900
Cumulative effect adjustment to accumulated deficit												$ (40,310)	$ 9,229	$ 0
Revenues	1,413,265	$ 949,828	$ 941,293	$ 858,435	$ 870,106	$ 784,535	$ 752,157	$ 640,799	$ 4,162,821	$ 3,047,597	$ 2,488,652
Accumulated Deficit
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cumulative effect adjustment to accumulated deficit												$ (40,310)	33,349	$ (9,371)
Accounting Standards Update 2014-09 | Accumulated Deficit
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cumulative effect adjustment to accumulated deficit													$ 8,300
ORKAMBI
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Revenues	$ 155,800